Laserfiche WebLink
STATE OF NEBRASKA <br />WHEN TH/S COPY CARR/ES THE RAISED SEAL OF THE NEBRASKA HEA�Fi��4Nt3 ,H�1� <br />SYSTEM, lT CERTIFIES THE BELOW TO BE A TRUE COPY OF THE ORXG�L f�E1G�fC4 <br />THE NEBRASKA HEALTH AND HUMAN SERVICES SYSTEM, VITAL ST,l��$�'1G�' <br />THE LEGAL DEPOSITORY FOR VITAL. RECORDS. f E _ ,_ <br />DATE OF ISSUANCE ` ;�� �- � �~ <br />APR 26 2007 2�1��`�9:�5 -- Ta!� <br />` �ts::�vr�x� <br />LINCOLN, NEBRASKA `,,�4��ID HUM <br />STATE Oi NEdRASKA—OEPARTMENT OF l�AI.1�_ -=.:: <br />BUREAU Of Yl�AL STAtlSTICS `= ? �-� <br />� � � � � � CERTIFICATE OF DE�TH `.�;������ Q ��:�: <br />DECECENT-NAME FIRST MID E tAST SfX � �,:�a DA E Of: <br />,. Joseph Edwasd Dunn z. I�'.31e W,. y T�3a <br />RAGE-(e.g., �Nhit�, Olock,Americon CRKiiN(GfSCENT(+.q.,bolinn,M�risaw, AGE-baicnAdo�r UNDER 1 YEARi 'UNDER 1 <br />Mdian. e1cJ f 5P«�wl C+�e�wn. �k.) fSp�ci�Yl (YrsJ MOS. � OAYS NOURS �' <br />1. ii�11ti6 S. ��1E-'Z1Cc'3T1 ba. 2 eb. �bc. � <br />ITY AND SUlTE Of OIRTM (N irot in U.S.A., CITI2EN QF WMAT t.OUNTRY MAR�ED, NEVER MARRIEO, NAME OF SP< <br />nonb eounkrl WIDOWfC, OiVOAGEO t 5petiy) <br />9. CirciYlCj IS�ACIC� 'G' 9. U� t0. .'". � 11• <br />SOGA► SECURfTY NUMdE� USUAL OCtU1AT10N pG'w� ki�d o/wo.k den� du.�ng nwsl KINO Of dUSINE55 QR INDUST <br />oi wrorking lih, �r�e if rdir�d) <br />�z. �5c��—:2-4b6z ��. , �3b. , �: _ <br />CITY, TOWN OR IOGATION OF pEATN INSiDE CITY iMAiTS MCSPITA� OR OTMER IN57tiUTIpN _ Non» fl! irof in �i <br />(SpKify Ya er No1 piw strNt and euA6�i1 <br />�ae I ik. ira. -Y i., <br />RESIDENCE - STATE COUNTY C1TY, TOWN OR IOCATION StREET AND NUMlER <br />�so. NeY��a�_ isb. h, �k. �sa <br />FA�M�R—�AM fiRST ' MIO L lA MER-MA1 N AME IRS <br />1 . 17. <br />, . _ ,, _ _ �1i�. -0��3(3 <br />WAS OECEASEO EVER IN U.S. ARMED FORCfSt INfORMANt-NAME—RELAi/ONSHti—MAl11NG ADOkESS (STREET Ot R:P.O. n0.. Gn OR tQwN, STATE. Zlry <br />�Yea. nu, w unk! �(14 y��. gt.� .oi � an0 dot�s of yena�) . . . <br />18. 19'' �• <br />SURUI, Cremation, Remavol OA1E CEMEiERY OR C MATORY - <br />200. 20b. , �:; i p '� .� <br />EMtAtMER-SiGNATURE 6 UGFNSE .2��� FUNENA! MO1r1F -N ANI <br />tl. t "S � <br />re N�. s..r o� wp rwe.t •� s ..a er rM. • ao c. / dv. + . <br />�� . caw�Ul asqd. � � � � . . <br />230. (Si na►on ewd T�} . � . l� <br />OATE IGNEO f .. Co . Yr.! HOU DE i„ <br />�� � - �' 7 ` � � r! . <br />� � 43b. 43c. .., <br />�` � OATE OF OEATM (�Mo., Dor. Y..y <br />f Z _ 2 G - r� <br />NAAAE ApORE55 CfRTIFI R(PMYSICIAN, GORONER'S PMM8IGIAN OR COUt� <br />, zs R. �t. �:6efoot, ii. D., 727 I1. ['ustex Ave <br />� REGISTRAR � � <br />� 26o.IS�y�roWn1� �'7� � <br />��7. IM�+lED1ATE CAUSE � (ENif� ONtY ONE CAUSE ifR LINf fpR (o), <br />PART i <br />t ( �r{.:�L-Z-� �'L�' ✓2�, <br />te� <br />RUE TO, AS A CONSfOUENCE OF. <br />�bl � �--�"i'4 / �'�-'� l- � . <br />OUE i0, OR AS A CONSEQUENGE Of: � <br />�e1 <br />� ►ART �TMER SIGnIfKAHi CONperiONS - Ca+dHiem cown�b��i�p ro d�orti bu� na .�lohd �►� <br />U �� <br />ACClOENi. SUiCIOE, 1fOAA1C10E, UNOfT .TDATF Of IN/URV (Me., Oay, Y. 1 XOUR Of INJI <br />Of �ENpHG INVEStIGAt10N (Spu�tr! � <br />30a. � � �• <br />� IMIUW 4T WO�I[ ►tAtE Of IN1U�r -/u Aew�, io..n. .n�N, 1a�fo.y... � <br />ISp�e:l� YM w Nel oiiit� buiidinp. Nt fSp�sil�) � <br />L 70�. 30f • <br />�ERY �,; � <br />7L����� +� ( , <br />�11G �r �; " f <br />� � <br />'� � �, <br />. � �;. �di4�Y1�'.. <br />-a.S -�' K i . <br />� � <br />�'��� <br />� _ <br />„-� 33D8 <br />t- <br />� *�� <br />i [Mo.. Dor. r..j <br />26�:' 1980 <br />DAfE Of btRTN lAAe., Oa�. Yr. <br />If NOS► OR INST. IwditaN pOA. <br />pa�pori�m/Ewu. R�.�. �npoA�ne {Sp�riryq <br />�vo <br />�,a. nn�t�_ent <br />� �NS�oe c�tr cu�its <br />tsP.c�y r.s o. No� . <br />(StREEi O� R.f.O NO. CItV OR TOWN. STATE. ZI�I L��U� <br />V <br />�i's,h�`� 'oeni,�, Grand Is1Und.r�e� <br />On H�� bwn ef wwsiaahon ondfer in»sNOetiaa. 111 1� O�lIR�11 �OM O[GYR� H <br />M� eiw, don ond plac� ond dw a Me couwld �wMd• <br />0 <br />21a. (Sionmun ond TN�► � <br />- �rMo..Ony, rr.) <br />e <br />' 2� . <br />lNEY) (fyp� or iri� <br />°and Islax <br />i1 fEMA►E. WAS TI <br />iCY fH TNE �AST � <br />�t� t i No 1 1� <br />MAR � 1 1984 <br />� � �w»nd bN.+.� e�.« onet d.e+h <br />� <br />R.i.D No <br />; lene�vot b��wM on�N end 6�aM <br />��InNrvni� ed IwM <br />i <br />NAS G� �EfE Mf I�CA► <br />:fIANYMER OR ! �, <br />�o«ry r•. o j � <br />9. <br />ein ae TowN srwTe <br />